=====================================================
General NPI Number Information
=====================================================
NPI Number | 1003735788
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PRABHJOT KAUR, DDS DENTAL CORPORATION
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/15/2026
-----------------------------------------------------
Last Update Date | 07/15/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 701 HIGHLAND SPRINGS AVE STE 11
-----------------------------------------------------
City | BEAUMONT
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92223-2550
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 213-344-8604
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 26149 PARK AVE UNIT 40
-----------------------------------------------------
City | LOMA LINDA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92354-6128
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 213-344-8604
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | THE PRESIDENT
-----------------------------------------------------
Name | PRABHJOT KAUR
-----------------------------------------------------
Credential | DDS
-----------------------------------------------------
Telephone | 213-344-8604
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QD0000X
-----------------------------------------------------
Taxonomy Name | Dental Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------